In 2005 the Amer­i­can Acad­emy of Pedi­atrics (AAP) began an ini­tia­tive to pro­mote an approach to care among its mem­bers in which “…the pedi­atric team works in part­ner­ship with a child and a child’s fam­ily to assure that all of the med­ical and non-medical needs of the patient are met.” A crit­i­cally impor­tant focus of this approach is the role of the fam­ily and child — as devel­op­men­tally appro­pri­ate — in the devel­op­ment of an over­all plan of care.

This shared decision-making approach is espe­cially impor­tant for con­di­tions like ADHD where there is not a sin­gle treat­ment that is the most appro­pri­ate and pre­ferred option for all patients. How­ever, Read the rest of this entry »

As you have prob­a­bly seen, the Cog­ni­tive Health and Brain Fit­ness field is rapidly evolv­ing, so let me high­light some of the main recent devel­op­ments affect­ing the field:

1) Pub­lic pol­icy ini­tia­tives:
– The Gov­ern­ment of Ontario, Canada, announced a $10m invest­ment in Bay­crest Research Cen­ter to help develop and com­mer­cial­ize brain fit­ness tech­nolo­gies. This $10m invest­ment was matched with an addi­tional $10m by local investors.
– In the US, The Paul Well­stone and Pete Domenici Men­tal Health Par­ity and Addic­tion Equity Act of 2008 was signed into law, included in the recently-approved eco­nomic bailout bill. The pas­sage of this law has sig­nif­i­cant impli­ca­tions for health­care providers and tech­nol­ogy ven­dors alike.

2) Com­put­er­ized Cog­ni­tive Assess­ments Used by the US Mil­i­tary:
The US Army launched a new pol­icy requir­ing cog­ni­tive screen­ings of all sol­diers before deploy­ment (in order to bet­ter diag­nose poten­tial prob­lems such as PTSD and TBI upon return). ANAM was the selected com­put­er­ized bat­tery of tests.

3) Ven­ture & Angel Fundrais­ing for Cog­ni­tive Train­ing com­pa­nies:
A num­ber of devel­op­ers have raised money. Cog­niFit received $5m (from Milk Cap­i­tal), Lumos Labs $3m (First­Mark Cap­i­tal –pre­vi­ously called Pequot Ventures-, Nor­west Ven­ture Part­ners), Sci­en­tific Brain Train­ing $1.5m (issued shares), Viv­ity Labs $1m (undis­closed angel investors), This is, of course, on top of the Feb­ru­ary $10.6 invest­ment in Dakim (Galen Part­ners) that we already included in our mar­ket report.

4) Major Ini­tia­tives by Insur­ance Com­pa­nies:
– All­state launched a large-scale research project to mea­sure impact of Posit Sci­ence InSight (visual pro­cess­ing train­ing) on dri­ver safety for adults over 50.
– OptumHealth announced a 3-year, $18m agree­ment with Brain Resource to offer web-based cog­ni­tive assess­ments as part of clin­i­cians’ deci­sion sup­port sys­tems.
– Humana decided not to renew its agree­ment with Posit Sci­ence to offer Posit’s audi­tory pro­cess­ing train­ing pro­gram to Medicare members.

5) New Research:
– In a sig­nif­i­cant new study, a team from the Uni­ver­sity of Michi­gan pub­lished a high-quality paper in the Pro­ceed­ings of the National Acad­emy of Sci­ences show­ing how com­put­er­ized work­ing mem­ory train­ing can gen­er­al­ize and improve fluid intel­li­gence (one of the domains that tends to decline with age).
– Learn­ing and Teach­ing Scot­land released an inter­nal study show­ing how Nin­tendo Brain Train­ing can help children’s math and con­cen­tra­tion skills. The study gained sig­nif­i­cant media atten­tion, despite the fact it hasn’t been pub­lished in a respected journal.

Note: This is an excerpt from the 6-Month Mar­ket Update we will  release later this month, cov­er­ing the many impor­tant devel­op­ments that have occurred since we launched the inau­gural Brain Fit­ness Mar­ket Report in March this year. This spe­cial report will be avail­able exclu­sively for our Pre­mium Research Spon­sors.

Quick links to excel­lent resources:

1) FEATURE-Brain fit­ness seen as hot indus­try of the future (Reuters)

2) Learn­ing & the Brain Con­fer­ence for Edu­ca­tors and Clin­i­cians. April 26–29, 2008. Cam­bridge, MA

3) Brain Health Across the Lifes­pan Sem­i­nar for Health & Aging Pro­fes­sion­als. May 15th, 2008. San Fran­cisco, CA

For more info, Read the rest of this entry »

Bill Gates deliv­ered a very inspir­ing com­mence­ment speech in Har­vard last week. I rec­om­mend read­ing the full Remarks of Bill Gates and reflect­ing on his core mes­sage, which may be sum­ma­rized in its last sentence:

• “And I hope you will come back here to Har­vard 30 years from now and reflect on what you have done with your tal­ent and your energy. I hope you will judge your­selves not on your pro­fes­sional accom­plish­ments alone, but also on how well you have addressed the world’s deep­est inequities  on how well you treated peo­ple a world away who have noth­ing in com­mon with you but their humanity.”

A note­wor­thy aspect of the speech was the dis­play of what neu­ropsy­chol­o­gists call Exec­u­tive Func­tions, which are mostly located in our Frontal Lobes–the most recent part of our brains in evo­lu­tion­ary terms, and that enable us to learn and adapt to new envi­ron­ments. What makes a “sharp brain”. You can read more about this in our post Exec­u­tive Func­tions and MacArthur “Genius Grants”.

See here Bill Gates’ advice on how to find solu­tions in com­plex environments-and how he applies a learned pat­tern to guide his actions in the field of AIDS prevention:

• “Cut­ting through com­plex­ity to find a solu­tion runs through four pre­dictable stages: deter­mine a goal, find the highest-leverage approach, dis­cover the ideal tech­nol­ogy for that approach, and in the mean­time, make the smartest appli­ca­tion of the tech­nol­ogy that you already have whether it’s some­thing sophis­ti­cated, like a drug, or some­thing sim­pler, like a bednet.”
• “The AIDS epi­demic offers an exam­ple. The broad goal, of course, is to end the dis­ease. The highest-leverage approach is pre­ven­tion. The ideal tech­nol­ogy would be a vac­cine that gives life­time immu­nity with a sin­gle dose. So gov­ern­ments, drug com­pa­nies, and foun­da­tions fund vac­cine research. But their work is likely to take more than a decade, so in the mean­time, we have to work with what we have in hand and the best pre­ven­tion approach we have now is get­ting peo­ple to avoid risky behavior.”
• “Pur­su­ing that goal starts the four-step cycle again. This is the pat­tern. The cru­cial thing is to never stop think­ing and work­ing  and never do what we did with malaria and tuber­cu­lo­sis in the 20th cen­tury  which is to sur­ren­der to com­plex­ity and quit.”
• “The final step  after see­ing the prob­lem and find­ing an approach  is to mea­sure the impact of your work and share your suc­cesses and fail­ures so that oth­ers learn from your efforts.”

Cer­tainly, good advice for us too to refine our Brain Fit­ness efforts. Here you have a rel­e­vant frag­ment of my (AF)recent inter­view with Dr. Elkhonon Gold­berg (EG):

AF: Please tell us more about what the Frontal Lobes are

EG: We researchers typ­i­cally call them the Exec­u­tive Brain. The pre­frontal cor­tex is young by evo­lu­tion­ary terms, and is the brain area crit­i­cal to adapt to new sit­u­a­tions, plan for the future, and self-regulate our actions in order to achieve long-term objec­tives. We could say that that part of the brain, right behind our fore­head, acts as the con­duc­tor of an orches­tra, direct­ing and inte­grat­ing the work of other parts of the brain.

I pro­vide a good exam­ple in The Exec­u­tive Brain book, where I explain how I was able to orga­nize my escape from Rus­sia into the US.

Sig­nif­i­cantly, the path­ways that con­nect the frontal lobes with the rest of the brain are slow to mature, reach­ing full oper­a­tional state between ages 18 and 30, or maybe even later. And, given that they are not as hard-wired as other parts of the brain, they are typ­i­cally the first areas to decline.

Well, I’d say Mr. Gates has pretty mature and solid pathways!